In a recently released review of published case reports, excluding those related to heparin administration, 98 drugs were listed with a definite or probable causal role for drug-induced thrombocytopenia. The most commonly implicated were quinidine, gold salts, and the combination drug trimethoprim-sulfamethoxazole.1- 3 Drug-induced thrombocytopenia is mostly produced by the autoimmune mechanism.4 A short-term drug treatment induction period, averaging 14 days, with a short recovery period after withdrawal of drug treatment, averaging 7 days, have been described.2 Although thrombocytopenia can be severe, major bleeding and death have been reported in only 9% and 0.8% of the cases, respectively, we reviewed in the literature.2 We report the case of a patient with severe thrombocytopenia, probably induced by levodopa, a side effect previously reported in only 1 case.5
Analytical evolution of thrombocytopenia related to levodopa treatment: Days refer to the admission date. Open downward-pointing arrow indicates the combination drug levodopa-carbidopa instead of the levodopa-benserazide combination; downward-pointing gray arrow, bromocriptine instead of the levodopa-carbidopa combination. The boxes at the top left indicate 1 platelet pooled transfusion at day 4 after admission and 2 platelet pooled transfusions on day 9 after admission.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 2
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.